Individual provider Active NPI

Amanda Jeannine Miller

  • Emergency Medicine Physician
  • Washington, DC
National Provider Identifier
1336646843
Registry record updated Jun 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD210002240 Issued in DC
Practice address
1310 Southern Ave SE
Washington, DC 20032
Phone
(202) 741-2911
Fax
(202) 741-2921
NPI assigned
Apr 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X MD210002240 DC Primary

Addresses

Primary practice location

1310 Southern Ave SE
Washington, DC 20032

Mailing address

1310 Southern Ave SE
Washington, DC 20032-4623
Phone (202) 741-2911

Other practice location 1

2120 L St NW Ste 450
Washington, DC 20037-1541
Phone (202) 715-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220726000261 DC Practitioner - Emergency Medicine 2567843329 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Temple University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Faculty Associates, IncGroup PAC ID 4082528898, 676 clinicians

Practice addresses (Care Compare)

1310 Southern Ave SE
Washington, DC 20032-4623
Phone (202) 574-7039

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Faculty Associates, Inc Emergency Medicine CurrentSince Jul 14, 2022 Accepting new patients
Medical Faculty Associates, Inc. Emergency Medicine PastSince May 1, 2022 Accepting new patients

Locations

1310 Southern Ave SE
Washington, DC 20032
Phone (202) 574-6000

900 23rd St NW
Washington, DC 20037
Phone (202) 715-4750

2120 L St NW
Ste 450
Washington, DC 20037
Phone (202) 741-2904

2150 Pennsylvania Ave NW
Washington, DC 20037
Phone (202) 741-2222

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1523404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1336646843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 SOUTHERN AVE SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200324623",
            "telephone_number": "202-741-2911",
            "fax_number": "202-741-2921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 SOUTHERN AVE SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "20032",
            "telephone_number": "202-741-2911",
            "fax_number": "202-741-2921"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2120 L St NW Ste 450",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200371541",
            "country_code": "US",
            "telephone_number": "202-715-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "AMANDA",
        "middle_name": "JEANNINE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-11",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "DC",
            "license": "MD210002240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.